State of Vaccine Manufacturing in India

Historically, vaccine manufacturing in India has centred around the production of a wide variety of conventional vaccines that made the country self-sufficient as well as a net exporter and global leader in supplying vaccines to low- and middle-income countries. However, over the course of time, other safe and efficacious vaccines that follow technologically more advanced manufacturing processes became available in the market and their increased uptake made the country import dependent. In the second half of the 2000s, when manufacturing capacity of the public sector was being dismantled, India became a big market for imported vaccines and export was affected adversely till recently.

Vaccines have been highly cost-effective in reducing death and morbidity caused by infectious diseases (GoI 2011). Vaccination prevents almost 6 million deaths annually from vaccine-preventable diseases (Ehreth 2003; Rodrigues and Plotkin 2020). It saved almost 14.4 million deaths from COVID-19 infection in first year itself between December 2020 and 2021 (Watson et al 2022). Despite these facts, many countries lack access to and coverage of recommended vaccination (Watson et al 2022). It is reported that countries having a robust vaccine manufacturing base in the public sector could make independent decisions on vaccine manufacturing and supply, provision, and introduction of vaccines in their respective health system in the past and achieved relatively high vaccination status (Khan 2021) as compared to the countries that have no/inadequate manufacturing capacity and rely largely on imported vaccines (Kumraj et al 2019). The need for in-house manufacturing capacity gained prominence during COVID-19 emergency when widespread lockdown and vaccine nationalism disrupted the vaccine supplies in developing (South Africa) countries (Makenga 2022). Timely and wider access to vaccines could have been facilitated effectively through local vaccine manufacturing, but vaccine development/manufacturing is a laborious and costly endeavour (Plotkin et al 2017). Therefore, many low-income countries, due to their financial and technological capacity constraints, have not been able to establish own manufacturing units and largely relying on import (Khan 2021). Vaccine manufacturing in high-income countries, however, get strong state support for vaccines’ research and development (Stevens 2011; Xue and Quellette 2020; Mani 2021; Cross et al 2021; Tull 2021).